Medi-Cal NEMT billing codes (HCPCS)

From the Medi-Cal provider manual, Medical Transportation – Ground:

• A0130: non-emergency transportation, wheelchair van.
• T2005: non-emergency transportation, stretcher van.
• A0380: mileage, per mile, for wheelchair and litter van transports only.
• A0425: ground mileage, per statute mile, for ambulance transports only.
• A0426 and A0428: non-emergency ambulance, advanced life support level 1 and basic life support.

• UJ: services at night, for transport between 7 p.m. and 7 a.m., with start and stop times on the claim.
• UN, UP, UQ, UR and US: two, three, four, five, and six or more patients served on one trip (see multi-load).
• DS followed by QN: a dry run.

Up to four modifiers are allowed on a line; modifier 99 is not. In fee-for-service the modifiers on the claim must match the ones on the TAR. Emergency and non-emergency codes can’t be on the same claim. Mileage goes on its own line, with the total miles from pickup to destination as the units.

These are the fee-for-service rules. Managed care plans and brokers publish their own billing guides and sometimes their own codes, so check each payer. Always bill from the current edition of the manual.